| NPI | 1679933154 |
|---|---|
| Doing Business As | SURPRISE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SHREEDEVI THULASIDAS Dentist 623-556-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D05975) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D07677) |
| 1223G0001X Dentist, General Practice (Licence: AZ D07677) | |
| 1223G0001X Dentist, General Practice (Licence: AZ D05975) | |
| 1223P0700X Dentist, Prosthodontics (Licence: AZ D07677) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-11-01 |